Anti-PD Pharm-Kisby Flashcards
1
Q
L-Dopa
A
- Pro-drug that does not cross BBB
- Immediate precursor of dopamine
- Restore synaptic DA levels
- SE: dyskinesias (choreiform movements)
2
Q
Entacapone & Tolcapone
A
- Selective and reversible COMT inhibitors
- Give with L-Dopa to increase efficacy
- SE: orange urine discoloration
3
Q
Carbidopa
A
- Give with L-Dopa to increase efficacy
4
Q
What is the “on-off” effect?
A
- Fluctuations in clinical response to L-Dopa
- Off = marked akinesia
- On = improved mobility but marked dyskinesia
5
Q
When would you use DA receptor agonists?
A
As monotherapy in early PD and adjunct in late PD
6
Q
Pramipexole, Ropinirole & Apomorphine
A
- DA receptor agonists
- SE: orthostatic hypotension, dykinesias, drowsiness, sleep attacks (Pramipexole)
7
Q
Selegiline (good for young pt) & Rasagiline (good for elderly)
A
- Selective irreversible inhibitors of MAO-B
- MAO-B metabolizes dopamine
- Can get party food effect
- SE: hypertensive crisis, fatal hyperthermia
8
Q
Trihexyphenidyl & Benzotropine
A
- Muscarinic receptor antagonists
- Decreases ACh in body
- Effective against tremors
- SE: mad as a hatter, hot as hades…
9
Q
Amantidine
A
- Antiviral drug with anti-PD properties
- Reduces L-dopa induced dyskinesias via NMDA inhibition
10
Q
What would you use to treat early onset PD?
A
Dopamine agonists (pramipexole, apomorphine, etc.)
11
Q
What would you use to treat late onset PD?
A
L-dopa
12
Q
What does a-synuclein build up cause?
A
Lewy-bodies
